Denying the right to healthcare: South Africa’s unemployed doctors at the centre of this crisis
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Abstract
The public sector provides healthcare access to 84% of patients in South Africa (SA). However, it is severely understaffed, with only 0.3 doctors per 1 000 people – far below the World Health Organization’s recommended ratio of 2.5 per 1 000. While the public sector struggles with numerous challenges, including a critical shortage of healthcare personnel, SA has a high number of medical doctors who have completed their mandatory community service yet remain unemployed. The shrinking health budget, rising salaries and high number of medicolegal claims are some of the reasons why the National Department of Health (NDoH) cannot afford to employ these professionals. In addition, corruption has severely impacted available resources, creating dangerous conditions in public hospitals. During the State of the Nation Address, the SA President announced the development of new healthcare facilities, but buildings alone do not deliver healthcare – people do. If the NDoH is already struggling to fill posts in the public sector, how can communities trust that adequate human resources have been budgeted for new facilities? Without proper staffing, these new facilities could exacerbate existing workforce shortages. The fundamental right to access healthcare is affirmed in the Constitution; however, its implementation is riddled with impediments. Although the issue of unemployed doctors is part of a bigger crisis within the SA healthcare sector, it is imperative that it is tackled first in order to avoid the further collapse of the healthcare system. This article highlights the government’s constitutional imperatives to the people of SA with regard to the right to access healthcare. It also brings to light certain factors that have accounted for the current state of healthcare in SA, and offers some recommendations toward urgent intervention. The article concludes by highlighting the need for strategic interventions that result in the integration of unemployed qualified doctors into the public healthcare system.
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References
1. Constitution of the Republic of South Africa, 1996. https://www.gov.za/ documents/constitution/constitution-republic-south-africa-04-feb-1997 (accessed 27 March 2025).
2. Brand South Africa. Eighteen years of the world’s best Constitution. December 2014. https://brandsouthafrica.com/94800/uncategorised/eighteen-years-of-the- world-s-best-constitution (accessed 18 March 2025).
3. South African Government. Register as a health professional. Government of South Africa, 2025. https://www.gov.za/services/services-residents/world-work/ professional-registration/register-health-professional (accessed 18 March 2025).
4. Zaghrah. South Africa faces healthcare crisis as 1 800 doctors remain jobless amid budget cuts. Joburg {etc}, 13 January 2025. https://www.joburgetc.com/news/ unemployed-doctors-south-africa/ (accessed 18 March 2025).
5. South Africa. Labour Relations Act No. 66 of 1995.
6. South African Commission for Conciliation, Mediation and Arbitration. Essential
and maintenance services: Frequently asked questions. Pretoria: CCMA, 2019.
https://labourguide.co.za/~documents/route%3A/download/1782#:~:text=n%20 213%20of%20the%20Labour%20Relations%20Act%2066,the%20 population%E2%80%9D%20It%20would%20have%20to%20be%20es (accessed 18 March 2025).
7. Bill of Rights. Section 27(2) of the Constitution of the Republic of South Africa, 1996.
8. Minister of Health and Others v Treatment Action Campaign and Others (No 2) (CCT8/02) (2002) ZACC 15; 2002 (5) SA 721 (CC); 2002 (10) BCLR 1033 (CC) (5 July 2002).
9. Government of the Republic of South Africa and Others v Grootboom and Others (CCT11/00) (2000) ZACC 19; 2001 (1) SA 46; 2000 (11) BCLR 1169 (4 October 2000).
10. Affordable Medicines Trust and Others v Minister of Health and Another (CCT27/04) (2005) ZACC 3; 2006 (3) SA 247 (CC); 2005 (6) BCLR 529 (CC) (11 March 2005).
11. Prinsen L. The leading causes of medicolegal claims and possible solutions. S Afr Med J 2023;113(4):1140-1142. https://doi.org/10.7196/SAMJ.2023.v113i4.134
12. McLaren D, Baduza M, Stevenson S, Chaskalson J. Opinion: Health budget
slashed despite vaccine commitment. Spotlight, 26 February 2021. https://www. spotlightnsp.co.za/2021/02/26/opinion-health-budget-slashed-despite-vaccine- commitments/ (accessed 5 March 2025).
13. South African Government. Minister Mzamo Buthelezi welcomes conclusion of Public Service 2025/26 negotiations. Government of South Africa, 20 February 2025. https://www.gov.za/news/media-statements/minister- mzamo-buthelezi-welcomes-conclusion-public-service%C2%A0202526 (accessed 18 March 2025).
14. Mahomed S, Loots G, Andrews G. COVID-19 millionaires must be held criminally accountable. S Afr J Bioethics Law 2020;13(2):81. https://doi.org/10.7196/ SAJBL.2020.v13i2.752
15. Transparency International. Corruption Perceptions Index. South Africa. Transparency International, 2024. https://www.transparency.org/en/countries/ south-africa (accessed 5 August 2025).
16. Calitz K. The plight of South African whistle-blowers: Searching for effective protection. Obiter 2023;44(4):828-857. https://doi.org/10.17159/obiter. v44i4.17592
17. Makhubu N. The rise and rise of quack doctors and possible damage to society. IOL, 11 December 2023. https://www.iol.co.za/sundayindependent/news/the- rise-and-rise-of-quack-doctors-and-possible-damage-to-society-4cbe6fdb-a028- 4338-b551-55497c44b92f (accessed 18 March 2025).
18. Kumiso Z. National Health Council approves 1 200 doctor positions amid systems overhaul. https://www.kaya959.co.za/news/health-council-approves- 1200-doctor-positions-amid-system-overhaul/ (accessed 22 April 2025).
19. Daniels N. 450 qualified doctors remain unemployed after community service. IOL, 9 January 2025. https://iol.co.za/capetimes/news/2025-01-09-450-qualified- sa-doctors-remain-unemployed-after-community-service/ (accessed 22 April 2025).